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Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety. | PSNet

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January 16, 2019 - Commentary Classic Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety. Citation Text: Bates DW, Singh H. Two Decades Since To Err Is Human: An Assessment Of Progress And Emerging Priorities In Patient Safety. H…

Clinically inconsequential alerts: the characteristics of opioid drug alerts and their utility in preventing adverse drug events in the emergency department. | PSNet

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May 18, 2022 - Study Clinically inconsequential alerts: the characteristics of opioid drug alerts and their utility in preventing adverse drug events in the emergency department. Citation Text: Genco EK, Forster JE, Flaten H, et al. Clinically Inconsequential Alerts: The Characteristics of Opioid Drug …

The extent and importance of unintended consequences related to computerized provider order entry. | PSNet

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May 27, 2011 - Study Classic The extent and importance of unintended consequences related to computerized provider order entry. Citation Text: Ash JS, Sittig DF, Poon EG, et al. The extent and importance of unintended consequences related to computerized provider order entry…

National surveillance of emergency department visits for outpatient adverse drug events in children and adolescents. | PSNet

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March 24, 2021 - Study National surveillance of emergency department visits for outpatient adverse drug events in children and adolescents. Citation Text: Cohen AL, Budnitz DS, Weidenbach KN, et al. National surveillance of emergency department visits for outpatient adverse drug events in children and …

Evaluation of perioperative medication errors and adverse drug events. | PSNet

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July 16, 2019 - Study Classic Evaluation of perioperative medication errors and adverse drug events. Citation Text: Nanji KC, Patel A, Shaikh S, et al. Evaluation of Perioperative Medication Errors and Adverse Drug Events. Anesthesiology. 2016;124(1):25-34. doi:10.1097/ALN.0000…

Did duty hour reform lead to better outcomes among the highest risk patients? | PSNet

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January 13, 2010 - Study Did duty hour reform lead to better outcomes among the highest risk patients? Citation Text: Volpp KG, Rosen AK, Rosenbaum PR, et al. Did duty hour reform lead to better outcomes among the highest risk patients? J Gen Intern Med. 2009;24(10):1149-55. doi:10.1007/s11606-009-1011-z…

Assessing the safety of electronic health records: a national longitudinal study of medication-related decision support. | PSNet

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July 29, 2020 - Study Assessing the safety of electronic health records: a national longitudinal study of medication-related decision support. Citation Text: Holmgren J, Co Z, Newmark L, et al. Assessing the safety of electronic health records: a national longitudinal study of medication-related decisio…

Adverse drug events among hospitalized Medicare patients: epidemiology and national estimates from a new approach to surveillance. | PSNet

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April 05, 2016 - Study Adverse drug events among hospitalized Medicare patients: epidemiology and national estimates from a new approach to surveillance. Citation Text: Classen D, Jaser L, Budnitz DS. Adverse drug events among hospitalized Medicare patients: epidemiology and national estimates from a new…

Analysis of iatrogenic and in-hospital medication errors reported to United States poison centers: a retrospective observational study. | PSNet

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November 28, 2018 - Study Analysis of iatrogenic and in-hospital medication errors reported to United States poison centers: a retrospective observational study. Citation Text: Leonard JB, McFadden C, Feemster AA, et al. Analysis of iatrogenic and in-hospital medication errors reported to United States pois…

Quality and variability of patient directions in electronic prescriptions in the ambulatory care setting. | PSNet

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May 08, 2017 - Study Quality and variability of patient directions in electronic prescriptions in the ambulatory care setting. Citation Text: Yang Y, Ward-Charlerie S, Dhavle AA, et al. Quality and Variability of Patient Directions in Electronic Prescriptions in the Ambulatory Care Setting. J Manag Car…

Preventable medication harm across health care settings: a systematic review and meta-analysis. | PSNet

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July 31, 2019 - Review Classic Preventable medication harm across health care settings: a systematic review and meta-analysis. Citation Text: Hodkinson A, Tyler N, Ashcroft DM, et al. Preventable medication harm across health care settings: a systematic review and meta-analysis…

Identifying adverse events in patients hospitalized in isolation or quarantine due to COVID-19. | PSNet

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September 13, 2023 - Study Identifying adverse events in patients hospitalized in isolation or quarantine due to COVID-19. Citation Text: de Arriba Fernández A, Sánchez Medina R, Dorta Hung ME, et al. Identifying adverse events in patients hospitalized in isolation or quarantine due to COVID-19. J Patient Sa…

A realist synthesis of pharmacist-conducted medication reviews in primary care after leaving hospital: what works for whom and why? | PSNet

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December 16, 2020 - Review A realist synthesis of pharmacist-conducted medication reviews in primary care after leaving hospital: what works for whom and why? Citation Text: Luetsch K, Rowett D, Twigg MJ. A realist synthesis of pharmacist-conducted medication reviews in primary care after leaving hospital: …

Awareness of diagnosis and follow up care after discharge from the emergency department | PSNet

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July 07, 2010 - Study Awareness of diagnosis and follow up care after discharge from the emergency department Citation Text: Leamy K, Thompson J, Mitra B. Awareness of diagnosis and follow up care after discharge from the Emergency Department. Australas Emerg Care. 2019;22(4):221-226. doi:10.1016/j.auec…

Improving patient safety in the ICU by prospective identification of missing safety barriers using the Bow-Tie prospective risk analysis model. | PSNet

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February 14, 2024 - Study Improving patient safety in the ICU by prospective identification of missing safety barriers using the Bow-Tie prospective risk analysis model. Citation Text: Kerckhoffs MC, van der Sluijs AF, Binnekade JM, et al. Improving Patient Safety in the ICU by Prospective Identification o…

Risk factors associated with medication ordering errors. | PSNet

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December 02, 2020 - Study Risk factors associated with medication ordering errors. Citation Text: Abraham J, Galanter WL, Touchette DR, et al. Risk factors associated with medication ordering errors. J Am Med Inform Assoc. 2021;18(1):86-94. doi:10.1093/jamia/ocaa264. Copy Citation Format: DOI …

Use of the revised second victim experience and support tool to examine second victim experiences of respiratory therapists. | PSNet

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November 03, 2021 - Study Use of the revised second victim experience and support tool to examine second victim experiences of respiratory therapists. Citation Text: Allender EA, Bottema SM, Bosley CL, et al. Use of the revised second victim experience and support tool to examine second victim experiences o…

"Are we there yet?" Ten persistent hazards and inefficiencies with the use of medication administration technology from the perspective of practicing nurses. | PSNet

psnet.ahrq.gov/issue/are-we-there-yet-ten-persistent-hazards-and-inefficiencies-use-medication-administration

August 04, 2021 - Study "Are we there yet?" Ten persistent hazards and inefficiencies with the use of medication administration technology from the perspective of practicing nurses. Citation Text: Taft T, Rudd EA, Thraen I, et al. “Are we there yet?” Ten persistent hazards and inefficiencies with the use …

Improving administration and documentation of enteral nutrition support therapy in a Veteran Affairs health care system: use of medication administration record and bar code scanning technology. | PSNet

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September 09, 2020 - Study Improving administration and documentation of enteral nutrition support therapy in a Veteran Affairs health care system: use of medication administration record and bar code scanning technology. Citation Text: Chew MM, Rivas S, Chesser M, et al. Improving administration and documen…

Characteristics and patient impact of boarding in the pediatric emergency department, 2018-2022. | PSNet

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October 19, 2022 - Study Characteristics and patient impact of boarding in the pediatric emergency department, 2018-2022. Citation Text: Kappy B, Berkowitz D, Isbey S, et al. Characteristics and patient impact of boarding in the pediatric emergency department, 2018–2022. Am J Emerg Med. 2023;77:139-146. do…

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